PMID- 32704453
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240329
IS  - 2167-8359 (Print)
IS  - 2167-8359 (Electronic)
IS  - 2167-8359 (Linking)
VI  - 8
DP  - 2020
TI  - Consolidation chemotherapy may improve pathological complete response for locally 
      advanced rectal cancer after neoadjuvant chemoradiotherapy: a retrospective 
      study.
PG  - e9513
LID - 10.7717/peerj.9513 [doi]
LID - e9513
AB  - BACKGROUND: Patients with locally advanced rectal cancer (LARC) have an improved 
      prognosis if achieved a pathological complete response (pCR) on account of 
      neoadjuvant chemoradiation therapy (nCRT). However, the proportion of patients 
      achieving pCR is only 8-24%. The purpose of this study was to explore whether the 
      addition of consolidation chemotherapy to nCRT could improve pCR rate in patients 
      with LARC. MATERIALS AND METHODS: The subjects were 144 individuals with clinical 
      stage II (T3-4, N0) or III (any T, N1-2) LARC who had received neoadjuvant CRT 
      followed by total mesorectal excision (TME). Eighty-three patients in the 
      consolidation chemotherapy group received two cycles XELOX between CRT and TME, 
      while 61 patients in the standard treatment group without consolidation 
      chemotherapy. The pCR (ypT0N0), tumor downstaging (ypT0-2N0) after TME and 
      adverse events (AEs) during and post treatment were compared between the 
      treatment groups using multivariable logistic regression analysis. To adjust the 
      unbalanced variables for the primary endpoint, logistic regression analysis and 
      stratified analysis were performed. RESULTS: The consolidation chemotherapy group 
      improved pCR rate (19.3% vs 4.9%, p = 0.01) and tumor downstaging rate (45.8% vs 
      24.6%, p = 0.009) compared to the standard treatment group. After adjustment for 
      clinical tumor stage, clinical nodal stage and time interval to surgery, patients 
      with consolidation chemotherapy were more likely to reach pCR (adjusted odds 
      ratio 4.91, 95% CI [1.01-23.79], p = 0.048). AEs during and post treatment in the 
      two groups were 54.1% vs 49.3% (p = 0.57), respectively. In addition, the 
      incidence of any grade 1-2 AEs in the two groups was 93.4% vs 95.1% (p = 0.93), 
      while the incidence of grade 3 AEs was 1.6% versus 2.4% (p = 0.74), respectively. 
      No grade 4 AEs occurred in two groups. CONCLUSIONS: The addition of neoadjuvant 
      consolidation chemotherapy after CRT significantly increased the pCR rate and did 
      not increase the AEs during and post treatment and in patients with LARC.
CI  - (c) 2020 Cui et al.
FAU - Cui, Jin
AU  - Cui J
AD  - Department of Graduate, Shandong First Medical University and Shandong Academy of 
      Medical Sciences, Jinan, Shandong, China.
AD  - Department of Radiation Oncology, Shandong Cancer Hospital and Institute, 
      Shandong First Medical University and Shandong Academy of Medical Sciences, 
      Jinan, Shandong, China.
FAU - Dou, Xue
AU  - Dou X
AD  - Department of Radiation Oncology, Shandong Cancer Hospital and Institute, 
      Shandong First Medical University and Shandong Academy of Medical Sciences, 
      Jinan, Shandong, China.
FAU - Sun, Yanlai
AU  - Sun Y
AD  - Department of Surgical Oncology, Shandong Cancer Hospital and Institute, Shandong 
      First Medical University and Shandong Academy of Medical Sciences, Jinan, 
      Shandong, China.
FAU - Yue, Jinbo
AU  - Yue J
AD  - Department of Radiation Oncology, Shandong Cancer Hospital and Institute, 
      Shandong First Medical University and Shandong Academy of Medical Sciences, 
      Jinan, Shandong, China.
LA  - eng
PT  - Journal Article
DEP - 20200707
PL  - United States
TA  - PeerJ
JT  - PeerJ
JID - 101603425
PMC - PMC7350921
OTO - NOTNLM
OT  - Colorectal cancer
OT  - Consolidation chemotherapy
OT  - Neoadjuvant chemoradiotherapy
OT  - TME
OT  - Tumor downstaging
OT  - pCR
COIS- The authors declare that they have no competing interests.
EDAT- 2020/07/25 06:00
MHDA- 2020/07/25 06:01
PMCR- 2020/07/07
CRDT- 2020/07/25 06:00
PHST- 2019/09/20 00:00 [received]
PHST- 2020/06/18 00:00 [accepted]
PHST- 2020/07/25 06:00 [entrez]
PHST- 2020/07/25 06:00 [pubmed]
PHST- 2020/07/25 06:01 [medline]
PHST- 2020/07/07 00:00 [pmc-release]
AID - 9513 [pii]
AID - 10.7717/peerj.9513 [doi]
PST - epublish
SO  - PeerJ. 2020 Jul 7;8:e9513. doi: 10.7717/peerj.9513. eCollection 2020.